Many nursing facilities across the United States have had a challenging time obtaining written consent for the COVID-19 vaccination for their residents. Both CVS and Walgreens, who will be vaccinating over 7 million residents and staff at over 75,000 nursing facilities, will now allow verbal confirmation for the consent of the COVID-19 vaccine.
Originally, both CVS and Walgreens indicated that written consent would be required for residents receiving the COVID-19 vaccine. Both pharmacies will now allow the verbal confirmation after many complaints from nursing facilities and patient advocate groups regarding the burdensome requirements and complicated consent forms. The Centers for Disease Control and Prevention (CDC), which is overseeing the pharmacy partnership, also said that verbal consent would be enough, and that there is no federal requirement for informed consent about immunizations.
Another issue that nursing facilities are dealing with is the reluctancy of staff to get vaccinated, despite the data that both vaccines from Moderna and Pfizer are safe. Therefore, many facilities are launching their own education campaigns, including filming the staff who are first in line, and having them explain why they wanted to be vaccinated. There are other facilities that are offering bonuses to their staff for taking the COVID-19 vaccine, which is using the money received through the federal CARES Act for the bonuses.
The pharmacies will make three visits to each nursing facility to ensure residents and staff receive their initial shot and booster. The residents and staff who take the vaccine will be fully vaccinated three to four weeks after the first visit, depending on which vaccine they receive.
Issue:
Obtaining written consent for the COVID-19 vaccines for residents within a nursing facility can be very challenging. When residents have cognitive difficulties and cannot sign for themselves, the Durable Power of Health Care Decisions must be contacted and asked to sign the consent form. In some cases, the consent form will be mailed out and then after signature obtained, it will be mailed back to the facility, and this can be a lengthy process. Now that verbal confirmation from an alert resident or from the DPOA can be allowed, the challenges are lessened. It is important as healthcare leaders that we ensure all residents, their families, and staff are educated on the COVID-19 vaccine, both the benefits and any possible side effects, prior to obtaining written or verbal consent for administration of the COVID-19 vaccine.
Discussion:
- Review your policies and procedures on administering the COVID-19 vaccine. Ensure that your policy has procedures in place for verbal confirmation of the COVID-19 vaccine. Update your policy if required.
- Educate all residents, their families, and staff regarding verbal confirmation for COVID-19 vaccine. Ensure staff who will be receiving verbal confirmations are aware of the procedure for documentation of the verbal confirmation.
- Audit medical records where verbal confirmation was received, and ensure that documentation follows the procedure outlined in your policy and procedure for COVID-19 vaccination.
